Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals

Abstract

Background:

Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces.

Research aim:

This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals.

Methods:

A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% (N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high.

Results:

The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments.

Conclusion:

Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

Keywords

Baby-Friendly Hospital Initiative breastfeeding breastfeeding barriers breastfeeding practices policy analysis socio-ecological model

Get full access to this article

View all access options for this article.

References

Alakaam

(2015). Hospital practices related to breastfeeding in Mississippi: A socio-ecological approach (Dissertation No. 178). Retrieved from http://aquila.usm.edu/dissertations/178

American Academy of Pediatrics. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841. doi:10.1542/peds.2011-3552

Baby-Friendly USA. (2017a). Find facilities. Retrieved from https://www.babyfriendlyusa.org/find-facilities

Baby-Friendly USA. (2017b). The Ten Steps to Successful Breastfeeding. Retrieved from http://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative/the-ten-steps

Boban

Zakarija-Grković

(2016). In-hospital formula supplementation of healthy newborns: Practices, reasons, and their medical justification. Breastfeeding Medicine, 11(9), 448-454. doi:10.1089/bfm.2016.0039

Centers for Disease Control and Prevention. (2015). mPINC state reports. Retrieved from http://www.cdc.gov/breastfeeding/data/mpinc/reports.htm

Centers for Disease Control and Prevention. (2016). Breastfeeding report card 2016. Retrieved from https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf

Centers for Disease Control and Prevention. (2017). Pregnancy Risk Assessment Monitoring System. Retrieved from https://www.cdc.gov/prams/pramstat/index.html

Communities and Hospitals Advancing Maternity Practices. (2017). Mississippi CHAMPS. Retrieved from http://www.cheerequity.org/mississippi-champs.html

10.

Contento

I. R.

(2011). Nutrition education: Linking research, theory, and practice. Sudbury, MA: Jones & Bartlett Learning.

11.

Cricco-Lizza

(2016). Infant feeding beliefs and day-to-day feeding practices of NICU nurses. Journal of Pediatric Nursing, 31(2), e91-e98. doi:10.1016/j.pedn.2015.10.012

12.

Crivelli-Kovach

Chung

E. K.

(2011). An evaluation of hospital breastfeeding policies in the Philadelphia metropolitan area 1994-2009: A comparison with the Baby-Friendly Hospital Initiative Ten Steps. Breastfeeding Medicine, 6(2), 77-84. doi:10.1089/bfm.2010.0009

13.

Daniels

Jackson

(2011). Knowledge, attitudes and practices of nursing staff regarding the Baby-Friendly Hospital Initiative in non-accredited obstetric units in Cape Town. South African Journal of Clinical Nutrition, 24(1), 32-38.

14.

Grove

S. K.

Burns

Gray

(2012). The practice of nursing research: Appraisal, synthesis, and generation of evidence. St. Louis, MO: Elsevier Health Sciences.

15.

Hellings

Howe

(2004). Breastfeeding knowledge and practice of pediatric nurse practitioners. Journal of Pediatric Health Care, 18(1), 8-14.

16.

Hudson

I. J.

Rutledge

Roberts Ayers

(2015). A case study of Michigan’s breastfeeding initiative: The role of coalitions in community-based breastfeeding support. Journal of Human Lactation, 31(4), 611-613. doi:10.1177/0890334415601358

17.

Chung

Raman

Chew

Magula

DeVine

. . . Lau

(2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment, (153), 1-186.

18.

Kahin

S. A.

McGurk

Hansen-Smith

West

Melcher

C. L.

(2017). Key program findings and insights from the Baby-Friendly Hawaii project. Journal of Human Lactation, 33(2), 409-414. doi:10.1177/0890334416683675

19.

Krumpal

(2013). Determinants of social desirability bias in sensitive surveys: A literature review. Quality & Quantity, 47(4), 2025-2047. doi:10.1007/s11135-011-9640-9

20.

Ashley

C. G.

Smiley

J. M.

Cohen

J. H.

Dee

D. L.

(2014). Associations of hospital staff training and policies with early breastfeeding practices. Journal of Human Lactation, 30(1), 88-96. doi:10.1177/0890334413484551

21.

Mississippi Breastfeeding Coalition. (2015). Breastfeeding resource guide. Retrieved from http://msbfc.org/index.php/resources/all

22.

Mississippi State Department of Health. (2014). 2013 report on hospitals. Retrieved from http://msdh.ms.gov/msdhsite/_static/resources/5906.pdf

23.

National Conference of State Legislatures. (2015). Breastfeeding state laws. Retrieved from http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx#State

24.

Nguyen

M. T.

Snow

Wheeler

Owens

(2016). Clinical question: In post-partum first-time mothers, what interventions are successful for helping women sustain exclusive breast feeding for one month or more? The Journal of the Oklahoma State Medical Association, 109(11), 521-524.

25.

Otsuka

Taguri

Dennis

C. L.

Wakutani

Awano

Yamaguchi

Jimba

(2014). Effectiveness of a breastfeeding self-efficacy intervention: Do hospital practices make a difference? Maternal and Child Health Journal, 18(1), 296-306. doi:10.1007/s10995-013-1265-2

26.

Rosenberg

K. D.

Stull

J. D.

Adler

M. R.

Kasehagen

L. J.

Crivelli-Kovach

(2008). Impact of hospital policies on breastfeeding outcomes. Breastfeeding Medicine, 3(2), 110-116. doi:10.1089/bfm.2007.0039

27.

Semenic

Childerhose

J. E.

Lauzière

Groleau

(2012). Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): An integrative review. Journal of Human Lactation, 28(3), 317-334. doi:10.1177/0890334412445195

28.

Smith

Moore

Peters

(2012). Implementing Baby-Friendly practices: Strategies for success. The American Journal of Maternal Child Nursing, 37(4), 228-233. doi:10.1097/NMC.0b013e318251054e

29.

Stokols

(1996). Translating social-ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10(4), 282-298.

30.

Taylor

E. C.

Nickel

N. C.

Labbok

M. H.

(2012). Implementing the ten steps for successful breastfeeding in hospitals serving low-wealth patients. American Journal of Public Health, 102(12), 2262-2268. doi:10.2105/AJPH.2012.300769

31.

Texas Department of State Health Services. (2012). Texas Ten Step Program—scorecard tool. Retrieved from http://texastenstep.org/wp-content/uploads/2012/09/Texas-Ten-Step-Scorecard.pdf

32.

U.S. Census Bureau. (2013). Metropolitan and micropolitan. Retrieved from https://www.census.gov/population/metro/data/metrodef.html

33.

U.S. Census Bureau. (2017). QuickFacts. Retrieved from https://www.census.gov/quickfacts/fact/map/MS,US/IPE120215#viewtop

34.

U.S. Department of Health and Human Services. (2015). Healthy people 2020. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives

35.

Wieczorek

C. C.

Marent

Dorner

T. E.

Dür

(2016). The struggle for inter-professional teamwork and collaboration in maternity care: Austrian health professionals’ perspectives on the implementation of the Baby-Friendly Hospital Initiative. BMC Health Services Research, 16, 91. doi:10.1186/s12913-016-1336-3

36.

World Health Organization. (2003). Global strategy for infant and young child feeding. Retrieved from http://www.who.int/nutrition/publications/gs_infant_feeding_text_eng.pdf